A different option in vascular bone grafts in the hand and wrist region: Use of a dorsoulnar artery-based osteo-fascio-cutaneous flap: A case series

Abstract

Objectives: This study aims to describe our surgery technique anddiscuss patients treated through the dorsoulnar artery (DUA)-basedtechnique of osseous and osteo-fascio-cutaneous vascularized ulnarbone grafting.Patients and methods: Between January 2011 and January 2015,six male patients (median age: 22.5 years; range, 20 to 24 years)who underwent surgery during which the technique of DUA ulnarbone graft was utilized. One patient with scaphoid nonunion, threepatients with Kienböck’s disease, and two patients with a traumaticmetacarpal defect were retrospectively evaluated. The joint range ofmotion (ROM), grip strength, Disabilities of the arm, shoulder andHand (DASH) questionnaire score and Visual Analog Scale (VAS)score, and radiographies before and after surgery were examined.Scintigraphy was performed at 12 weeks postoperatively to monitorthe viability of the bone graft.Results: All patients showed improvements in the ROM, gripstrength, VAS, and DASH scores. According to the radiographicexamination, bone union was achieved in all patients and thescintigraphy revealed that vascularization was detected in the bonetissue.Conclusion: The advantages of DUA-based vascularized bone graftare good bone quality and quantity and versatility due to its longpedicle. The osteo-fasio-cutaneous DUA flap seems to be effective inthe treatment of traumatic metacarpal bone defects accompanied byskin loss. The DUA-based vascularized ulnar bone may be a sourcefor scaphoid and lunate biological bone reconstruction.